Correspondence Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement 1U58 DP000807-01 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors, and endorsement by the State of California, the California Department of Health Care Services, the National Cancer Institute, or the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.
CONFLICT OF INTEREST DISCLOSURES Dr. Gomez was supported by a grant from Genentech for work performed outside of the current study.
ACKNOWLEDGMENTS We would like to acknowledge Meg McKinley, Kathleen Gali, and Heather Wakelee for contributions to the current study. REFERENCES 1. National Cancer Institute, National Institutes of Health. Surveillance, Epidemiology, and End Results Review, 1973-2008. seer.cancer.gov/ 2011update.html. Accessed March 26, 2014. 2. Centers for Disease Control and Prevention. Lung Cancer Statistics. cdc.gov/cancer/lung/statistics/index.htm. Accessed March 26, 2014. 3. Centers for Disease Control and Prevention. National Health Interview Survey. cdc.gov/nchs/nhis.htm. Accessed March 26, 2014. 4. National Cancer Institute Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Lung and Bronchus Cancer. seer.gov/statfacts/html/lungb.html. Accessed August 1, 2014. 5. Lewis DR, Check DP, Caporaso NE, Travis WD, Devesa SS. US lung cancer trends by histologic type. Cancer. 2014;120:28832892. 6. Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male:female differences diminishing and adenocarcinoma rates rising. Int J Cancer. 2005;117:294-299. 7. Yu M, Feuer EJ, Cronin KA, Caporaso NE. Use of multiple imputation to correct for bias in lung cancer incidence trends by histologic subtype. Cancer Epidemiol Biomarkers Prev. 2014;23:1546-1558. 8. American Lung Association. Trends in Tobacco Use. lung.org/finding-cures/our-research/trend-reports/Tobacco-Trend-Report.pdf. Accessed May 14, 2014.
Manali I. Patel, MD, MPH Division of Oncology Clinical Excellence Research Center Department of Medicine Stanford University School of Medicine Stanford, CA
Iona C. Cheng, PhD Cancer Prevention Institute of California Fremont, California
Scarlett Lin Gomez, PhD Department of Health Research and Policy Stanford University School of Medicine Stanford, California; Cancer Prevention Institute of California Fremont, California DOI: 10.1002/cncr.29180, Published online December 2, 2014 in Wiley Online Library (wileyonlinelibrary.com)
1152
Reply to US Lung Cancer Trends by Histologic Type We thank Patel et al for their comments regarding our article.1 Their investigation includes an additional year beyond ours and uses an alternate complementary joinpoint analytic method, and the findings are generally similar. Rates aggregated over several years are more stable than single-year rates and allow general patterns to emerge in both the cancer and smoking trends, although the exact year when trends changed cannot be discerned. The joinpoint method used by Patel et al uses single-year rates and allows for the estimation of the year when trends change and the associated annual percent changes (APCs). However, it may be difficult to interpret a significant change in trend when based on relatively few years, especially when the age-specific, cohort-specific patterns have been so complex. Patel et al found recent rising adenocarcinoma rates among most groups, as did we, but we wonder about their reported recent significant decline among Hispanic males. During what years did that occur? They also report significant increases during 2004 through 2009 (APC, 7.9%) followed by significant decreases between 2009 and 2011 (APC, 217.4%) of small cell carcinoma among Hispanic females. The segment for 2009 through 2011 is based on only 3 years of data, and recent rates likely will increase in subsequent submissions, related to the concept of delay adjustment recognized by the Surveillance, Epidemiology, and End Results program.2 We do not know how to interpret the reported APC of 10.3 (95% confidence interval, 20.2 to 20.7) for adenocarcinoma for 1992 through 2005 or the APC of 25 for 1992 through 2004 along with an embedded segment of an APC of 21.7 for 1996 through 1999 for small cell carcinoma among non-Hispanic white females. Is it valid to compare the APCs of the declining category of not otherwise specified with the increasing specified-type APCs rather than comparing changes in the absolute rates? Improvements in pathology and genomic technology are identifying new specific carcinoma types, recorded in the medical records, and then abstracted and coded. It is an interesting speculation by Patel et al that the quality of pathology review for some racial groups might be of lesser quality than for others. We found remarkable consistency across the racial/ethnic/sex groups with regard to the changing trends for the unspecified and adenocarcinoma groups, suggesting that the improvements have Cancer
April 1, 2015
Correspondence
occurred across wide segments of the population. Indeed, Patel et al reported that the recent increases in female adenocarcinoma were most rapid among Hispanic individuals, intermediate among non-Hispanic black individuals, and slowest among non-Hispanic white individuals (APCs of 5.8%, 3.2%, and 2.4%, respectively). Furthermore, the significant increase in adenocarcinoma observed among Hispanic females contrasts sharply with the decline noted among Hispanic males, because unequal access to quality pathology review and medical care would not be expected by sex. We agree that more research is needed to better understand the demographic differences in lung cancer rates by histologic type. FUNDING SUPPORT No specific funding was disclosed.
CONFLICT OF INTEREST DISCLOSURES The authors made no disclosures.
Cancer
April 1, 2015
REFERENCES 1. Lewis DR, Check DP, Caporaso NE, Travis WD, Devesa SS. US lung cancer trends by histologic type. Cancer. 2014;120:28832892. 2. Howlader N, Noone AM, Krapcho M, et al, eds. Cancer Statistics Review, 1975-2011. Bethesda, MD: National Cancer Institute; 2014.
Denise Riedel Lewis, PhD, MPH Surveillance Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda, Maryland
William D. Travis, MD Department of Pathology Memorial Sloan-Kettering Cancer Center New York, New York
Susan S. Devesa, PhD Epidemiology and Biostatistics Program Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda, Maryland DOI: 10.1002/cncr.29179, Published online December 23, 2014 in Wiley Online Library (wileyonlinelibrary.com)
1153
Copyright of Cancer (0008543X) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
CONFLICT OF INTEREST DISCLOSURES Dr. Gomez was supported by a grant from Genentech for work performed outside of the current study.
ACKNOWLEDGMENTS We would like to acknowledge Meg McKinley, Kathleen Gali, and Heather Wakelee for contributions to the current study. REFERENCES 1. National Cancer Institute, National Institutes of Health. Surveillance, Epidemiology, and End Results Review, 1973-2008. seer.cancer.gov/ 2011update.html. Accessed March 26, 2014. 2. Centers for Disease Control and Prevention. Lung Cancer Statistics. cdc.gov/cancer/lung/statistics/index.htm. Accessed March 26, 2014. 3. Centers for Disease Control and Prevention. National Health Interview Survey. cdc.gov/nchs/nhis.htm. Accessed March 26, 2014. 4. National Cancer Institute Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Lung and Bronchus Cancer. seer.gov/statfacts/html/lungb.html. Accessed August 1, 2014. 5. Lewis DR, Check DP, Caporaso NE, Travis WD, Devesa SS. US lung cancer trends by histologic type. Cancer. 2014;120:28832892. 6. Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male:female differences diminishing and adenocarcinoma rates rising. Int J Cancer. 2005;117:294-299. 7. Yu M, Feuer EJ, Cronin KA, Caporaso NE. Use of multiple imputation to correct for bias in lung cancer incidence trends by histologic subtype. Cancer Epidemiol Biomarkers Prev. 2014;23:1546-1558. 8. American Lung Association. Trends in Tobacco Use. lung.org/finding-cures/our-research/trend-reports/Tobacco-Trend-Report.pdf. Accessed May 14, 2014.
Manali I. Patel, MD, MPH Division of Oncology Clinical Excellence Research Center Department of Medicine Stanford University School of Medicine Stanford, CA
Iona C. Cheng, PhD Cancer Prevention Institute of California Fremont, California
Scarlett Lin Gomez, PhD Department of Health Research and Policy Stanford University School of Medicine Stanford, California; Cancer Prevention Institute of California Fremont, California DOI: 10.1002/cncr.29180, Published online December 2, 2014 in Wiley Online Library (wileyonlinelibrary.com)
1152
Reply to US Lung Cancer Trends by Histologic Type We thank Patel et al for their comments regarding our article.1 Their investigation includes an additional year beyond ours and uses an alternate complementary joinpoint analytic method, and the findings are generally similar. Rates aggregated over several years are more stable than single-year rates and allow general patterns to emerge in both the cancer and smoking trends, although the exact year when trends changed cannot be discerned. The joinpoint method used by Patel et al uses single-year rates and allows for the estimation of the year when trends change and the associated annual percent changes (APCs). However, it may be difficult to interpret a significant change in trend when based on relatively few years, especially when the age-specific, cohort-specific patterns have been so complex. Patel et al found recent rising adenocarcinoma rates among most groups, as did we, but we wonder about their reported recent significant decline among Hispanic males. During what years did that occur? They also report significant increases during 2004 through 2009 (APC, 7.9%) followed by significant decreases between 2009 and 2011 (APC, 217.4%) of small cell carcinoma among Hispanic females. The segment for 2009 through 2011 is based on only 3 years of data, and recent rates likely will increase in subsequent submissions, related to the concept of delay adjustment recognized by the Surveillance, Epidemiology, and End Results program.2 We do not know how to interpret the reported APC of 10.3 (95% confidence interval, 20.2 to 20.7) for adenocarcinoma for 1992 through 2005 or the APC of 25 for 1992 through 2004 along with an embedded segment of an APC of 21.7 for 1996 through 1999 for small cell carcinoma among non-Hispanic white females. Is it valid to compare the APCs of the declining category of not otherwise specified with the increasing specified-type APCs rather than comparing changes in the absolute rates? Improvements in pathology and genomic technology are identifying new specific carcinoma types, recorded in the medical records, and then abstracted and coded. It is an interesting speculation by Patel et al that the quality of pathology review for some racial groups might be of lesser quality than for others. We found remarkable consistency across the racial/ethnic/sex groups with regard to the changing trends for the unspecified and adenocarcinoma groups, suggesting that the improvements have Cancer
April 1, 2015
Correspondence
occurred across wide segments of the population. Indeed, Patel et al reported that the recent increases in female adenocarcinoma were most rapid among Hispanic individuals, intermediate among non-Hispanic black individuals, and slowest among non-Hispanic white individuals (APCs of 5.8%, 3.2%, and 2.4%, respectively). Furthermore, the significant increase in adenocarcinoma observed among Hispanic females contrasts sharply with the decline noted among Hispanic males, because unequal access to quality pathology review and medical care would not be expected by sex. We agree that more research is needed to better understand the demographic differences in lung cancer rates by histologic type. FUNDING SUPPORT No specific funding was disclosed.
CONFLICT OF INTEREST DISCLOSURES The authors made no disclosures.
Cancer
April 1, 2015
REFERENCES 1. Lewis DR, Check DP, Caporaso NE, Travis WD, Devesa SS. US lung cancer trends by histologic type. Cancer. 2014;120:28832892. 2. Howlader N, Noone AM, Krapcho M, et al, eds. Cancer Statistics Review, 1975-2011. Bethesda, MD: National Cancer Institute; 2014.
Denise Riedel Lewis, PhD, MPH Surveillance Research Program Division of Cancer Control and Population Sciences National Cancer Institute Bethesda, Maryland
William D. Travis, MD Department of Pathology Memorial Sloan-Kettering Cancer Center New York, New York
Susan S. Devesa, PhD Epidemiology and Biostatistics Program Division of Cancer Epidemiology and Genetics National Cancer Institute Bethesda, Maryland DOI: 10.1002/cncr.29179, Published online December 23, 2014 in Wiley Online Library (wileyonlinelibrary.com)
1153
Copyright of Cancer (0008543X) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
